Epidemiology and Management Cost of Myocardial Infarction in North Punjab, Pakistan

Abstract

Background: Coronary heart disease (CHD) is an important cause of morbidity and mortality in Pakistan. The temporal trends in the risk factors for myocardial infarction (MI) and the impact of socioeconomic status on these risk factors remain ambiguous. Objectives: The objectives of the present analysis were to investigate the potential association between various risk factors and MI in North Punjab, Pakistan, and to assess the status of the control of the risk factors associated with MI in this population. Patients and Methods:The present study included 515 patients admitted to the coronary care units or equivalent cardiology wards of the participating hospitals between 2011 and 2012 in North Punjab, Pakistan. The analysis was focused on identifying the socioeconomic status, lifestyle, family history of MI, and risk factors (i.e. hypertension, diabetes, smoking, and hyperlipidemia). A structured questionnaire was designed to collect data. The lipid profile was recorded from the investigation chart of every patient. For statistical analysis, the Kruskal Wallis, Mann-Whitney U, Wilcoxon, and chi-square tests were used. Results: MI was common in the males at the age of 41 -60 years as compared to the females (P = 0.015). Patients with a positive parental history of CHD experienced MI at a younger age (P = 0.0001) at a body mass index (BMI) ≤ 25 kg/m 2 . Sedentary lifestyle (70%) and smoking (60%) had a male predominance. Hypertension accounted for nearly 37%, hyperlipidemia 26%, and diabetes 19.4% of the rural and urban subjects (P < 0.01). High-density lipoprotein cholesterol decreased (up to 34 mg/dl), while low-density lipoprotein cholesterol and hypertension increased with age. The mean monthly cost of medicines and physicians' fees per patient was 2381.132 Pakistani Rupees (24.24 USD). Conclusions: Higher BMI, positive family history, smoking, hypertension, hyperlipidemia, and diabetes were the strong predictors of MI in North Punjab, Pakistan. Preventive efforts are needed to start early in life and continue throughout the life course.

Common Risk Factors of Myocardial Infarction and Some Socio Demographic Characteristics in Sulaimani City

“…Therefore, it seems that our patients have a low quality of marital status. Also, the present study found that male patients were more than females (74.5, 25.5%) respectively; which agrees with the previous study; these differences can be explained by the cardio-protective effect of endogenous estrogen [9]. The present study is not without limitations.…”

“…The prevalence of hypertension, dyslipidemia, and diabetes was (61%, 39.4%, and 20%) respectively. Our finding for hypertension and dyslipidemia was higher than (Iqbal et al,2015) in Pakistan, who documented that hypertension accounted for nearly (37%) and more than a quarter for hypercholesterolemia [9]. Nevertheless, the present outcome is similar to the result of their study for diabetes mellitus (19.4%) in the rural and urban focuses.…”

“…The maximum age-adjusted death from coronary heart disease is in Asian countries and had, followed by West Asian, Southeast Asian, and South Asian countries [8]. The most susceptible population to MI is Asian people [9]. A rapid transformation of the societies has occurred from nomadic or rural lifestyles to urban lifestyles over the last six or seven decades in classified countries of the middle east region which consists of mainly high, middle, and low-income countries [10].…”

Hypertension;

“…In a study conducted in northern Punjab, myocardial infarction due to chronic hypertension was common in males at the age of 41-60 years. 10 CVDs are also associated with risk factors such as overweight and obesity, lack of physical activity and unhealthy diet. BMI is an easy to measure indicator for obesity.…”

Periodontitis and Myocardial Infarction Risk: A Case-Control Study

“…14 The demographic risk factor assessment showed a male predominance in both the case and control groups (80% and 74.5%) with an age range of 25 2017), who also reported a higher occurrence of periodontitis as well as MI in male population as compared to females. [16][17] This is attributed to ignorance of poor oral hygiene practices among males and psychosocial stresses experienced by men in our society which is the primary risk factor of periodontitis. Studies also found that men of middle age are 2-5 times at a higher risk of developing MI as compared to females who are protected against risk of Chronic heart diseases (CHD) owing to the higher estrogen levels.…”